Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Horten, Norway.
BMC Public Health. 2022 Apr 11;22(1):720. doi: 10.1186/s12889-022-13007-0.
To prevent type 2 diabetes mellitus (T2D) and reduce the risk of complications, early identification of people at risk of developing T2D, preferably through simple diabetes risk scores, is essential. The aim of this study was to create a risk score for identifying subjects with undiagnosed prediabetes or T2D among Saharawi refugees in Algeria and compare the performance of this score to the Finnish diabetes risk score (FINDRISC).
A cross-sectional survey was carried out in five Saharawi refugee camps in Algeria in 2014. A total of 180 women and 175 men were included. HbA1c and cut-offs proposed by the American Diabetes Association (ADA) were used to define cases. Variables to include in the risk score were determined by backwards elimination in logistic regression. Simplified scores were created based on beta coefficients from the multivariable model after internal validation with bootstrapping and shrinkage. The empirical cut-off value for the simplified score and FINDRISC was determined by Area Under the Receiver Operating Curve (AUROC) analysis.
Variables included in the final risk score were age, body mass index (BMI), and waist circumference. The area under the curve (AUC) (C.I) was 0.82 (0.76, 0.88). The sensitivity, specificity, and positive and negative predictive values were 89, 65, 28, and 97%, respectively. AUC and sensitivity were slightly higher and specificity somewhat lower than for FINDRISC.
The risk score developed is a helpful tool to decide who should be screened for prediabetes or T2D by blood sample analysis. The performance of the risk score was adequate based on internal validation with bootstrap analyses, but should be confirmed in external validation studies.
为了预防 2 型糖尿病（T2D）并降低并发症风险，早期识别有发生 T2D 风险的人群至关重要，最好通过简单的糖尿病风险评分来实现。本研究旨在建立一种风险评分，用于识别阿尔及利亚撒哈拉难民中未确诊的前驱糖尿病或 T2D 患者，并比较该评分与芬兰糖尿病风险评分（FINDRISC）的表现。
2014 年在阿尔及利亚的五个撒哈拉难民营中进行了一项横断面调查。共纳入 180 名女性和 175 名男性。使用美国糖尿病协会（ADA）提出的 HbA1c 和切点来定义病例。通过向后逐步回归法确定风险评分中包含的变量。根据多变量模型的贝塔系数，在内部验证中使用 bootstrap 法和收缩法创建简化评分。简化评分和 FINDRISC 的经验截止值通过接收者操作特征曲线（AUROC）分析确定。
最终风险评分中包含的变量有年龄、体重指数（BMI）和腰围。曲线下面积（AUC）（置信区间）为 0.82（0.76，0.88）。敏感性、特异性、阳性预测值和阴性预测值分别为 89%、65%、28%和 97%。AUC 和敏感性略高于 FINDRISC，特异性略低。
该开发的风险评分是一种有用的工具，可以决定谁应该通过血液样本分析进行前驱糖尿病或 T2D 的筛查。基于 bootstrap 分析的内部验证，该风险评分的性能良好，但应在外部验证研究中得到证实。
